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The Integrative Oncology Scholars Program: Indoctrinating oncology professionals into pseudoscience

“Integrative oncology” involves “integrating” pseudoscience, mysticism, and quackery with science-based oncology and co-opting science-based lifestyle modalities as “alternative” in order to provide cover for the quackery. Unfortunately, my alma mater, funded by the National Cancer Institute, is running a course to indoctrinate 100 health care professionals in the ways of “integrative oncology.” The Trojan horse of “lifestyle interventions” and “nonpharmacologic treatments for pain” is at the gates. The quackery will leap out as soon as it’s in the fortress.

Three weeks ago, I wrote about a whole “Special Focus” issue of the flagship journal for integrating quackery into medicine, the Journal of Alternative and Complementary Medicine (JACM). The issue was devoted to “integrative oncology,” which I view as being devoted to “integrating” mysticism, quackery, and pseudoscience into the clinical care of cancer patients while co-opting diet, exercise, and lifestyle interventions as somehow being “integrative” or “alternative” rather than part of conventional medicine, the better to provide cover for quackery like traditional Chinese medicine, energy medicine, and the like. Because the Special Focus issue was going to be available for free until October 24, I had planned on writing a follow-up post, but somehow (as is often the case) other topics intervened. Then, over the weekend, our very own Jann Bellamy sent me a PubMed link to an article from that issue touting something called the “Integrative Oncology Scholars Program”. I had mentioned that article in my previous loving deconstruction of the JACM integrative oncology Special Focus issue, but Jann’s email jolted me, making me realize that I really should have written more about this particular aspect, particularly given that it’s being spearheaded by my alma mater, both undergraduate and medical, the University of Michigan.

The article is, as is often the case for articles like this, credited to many authors, but the first (and corresponding) author is Suzanna Zick, a naturopath who is in charge of the Integrative Family Medicine program in the Department of Family Medicine at the University of Michigan, where she’s been teaching what I consider to be misinformation and retconned history about traditional Chinese medicine and hosting homeopaths for Family Medicine Grand Rounds, all while publishing dodgy acupressure papers. I also note that the Integrative Family Medicine program at U. of M. purports to provide “advanced training in holistic medicine, anthroposophic medicine, and acupuncture”. Anthroposophic medicine, as you might recall, was first invented by Rudolf Steiner, and it is loaded with mystical nonsense. Yet my alma mater has a program in it.

How did a naturopath find a faculty position in the family medicine department of what has traditionally been a bastion of science-based medicine? I have no idea, but it’s been a source of continual embarrassment to me ever since I discovered it. After all, U. of M. is my alma mater, and I still collaborated with U. of M. faculty as recently as 2017. It also doesn’t help that Zick is a player in the Society for Integrative Oncology (SIO), having been president of the organization a couple of years ago and having had integral (if you’ll excuse the term) involvement in drafting the SIO’s dubious guidelines for the integrative oncological care of breast cancer patients, an updated version of which, alas, was recently endorsed by the American Society of Clinical Oncology (ASCO).

So let’s take a look at what Zick et al have written, “Integrative Oncology Scholars Program: A Model for Integrative Oncology Education“.

The Integrative Oncology Scholars Program: Framing the frame

Basically, the Integrative Oncology Scholars Program is all about increasing the number of oncology professionals who buy into integrative oncology. (Note that I will quote fairly liberally, because after October 24, this article will go behind a paywall.) It all begins, as is usual for articles promoting “integrative medicine”, with framing integrative medicine as very, very popular, and therefore:

Despite this high level of use, communication about complementary and integrative medicine (CIM) use between oncology providers and patients is not ideal. Over half of oncology providers do not ask about CIM use3,4 and indicate the main reasons being a lack of knowledge about CIM approaches and not knowing what to do with the information once collected.3,5,6 This lack of communication can leave patients and their families with many unanswered questions, can result in negative (e.g., herb–drug) interactions and toxicities,7,8 and may prevent patients and survivors from receiving treatments that could help reduce cancer treatment side-effects and improve quality of life.9 Also, while the majority of CIM treatments are being delivered in the community by complementary providers, few oncology professionals and complementary providers communicate or are aware of the others’ practice. Oncology professionals rarely refer patients to complementary providers, with oncologists only referring for more information about complementary therapies 16% of the time, and nurses and social workers 13% and 36% of the time, respectively.4,10 One possible solution to the unsatisfactory interaction around CIM for both patients and providers (conventional and complementary) is education.

Of course, I’m all for education, as long as it’s based on science rather than promotion. Oncology professionals—heck, all physicians, nurses, physicians assistants, and anyone who gives medical advice to patients for a living—should have a working knowledge of “complementary and alternative medicine” (CAM) or “integrative medicine”. There’s the rub, though. I insist upon science-based education, which demonstrates that the vast majority of CAM doesn’t work and that which does work, such as exercise, science-based dietary modifications, and the like, is almost always already part of conventional medicine. (Low carb diet and weight loss as initial interventions for type II diabetes, anyone?)

It’s all about demand, though; that is, if you believe Zick et al. She and her co-authors are only doing this in response to overwhelming provider demand:

Oncology providers have expressed a desire to be more informed and to receive more education about oncology-specific CIM.6,11 Until recently, however, no oncology-specific CIM training has been available and the majority of educational opportunities have been designed for physicians (e.g., in the form of fellowships), despite the multidisciplinary and growing professional diversity of oncology teams.12 In response to this educational gap, we have designed the Integrative Oncology Scholars (IOS) Program.

See? We perceived a huge need for this education in “complementary and integrative medicine” (CIM). (I wish advocates of CAM, CIM, or whatever would make up their mind on what acronym they want to use.) So what will this program consist of?

The Integrative Oncology Scholars Program: The course

Now that the authors have established the desperate “need” for this education on integrating nonsense into oncology, how do they propose to provide for this need? The answer is simple. The authors have devised a program with the following goals:

The IOS Program is funded by a National Cancer Institute R25 grant. It has the joint goals of training 100 integrative oncology (IO) leaders over 4 years and facilitating partnerships between IO leaders and complementary practitioners within their communities. Eligible participants, who are designated as IOS, include a multidisciplinary selection of physicians, physician assistants, nurses, psychologists, social workers, physical or occupational therapists, and pharmacists, who are actively engaged in clinical oncology practice. IOS instructors are experts in the field of IO and/or adult education and reflect the multidisciplinary nature of the program with professions as diverse as patient advocates to oncology clinicians. Details on course instructors, program eligibility, and how to apply are available on the IOS Program website.*

An R25 grant from the NIH is, basically, an education grant whose purpose is “to support research education activities that: (a) Complement and/or enhance the training of a workforce to meet the nation’s biomedical, behavioral and clinical research needs; (b) Enhance the diversity of the biomedical, behavioral and clinical research workforce; (c) Help recruit individuals with specific specialty or disciplinary backgrounds to research careers in biomedical, behavioral and clinical sciences; or (d) Foster a better understanding of biomedical, behavioral and clinical research and its implications.”

This particular R25 grant (R25 CA203651), entitled A short course for creating integrative oncology leaders, is, surprisingly, not a grant issued by the National Center for Complementary and Integrative Health (NCCIH), but rather from the National Cancer Institute. Not surprisingly, Suzanna Zick is the principal investigator. It’s not a huge grant, but it’s a decent chunk of change ($220,155 to $237,612 per year thus far). Its specific aims include:

  1. Develop an interdisciplinary short-course in evidenced-based integrative oncology;
  2. Train 100 integrative oncology leaders (25 participants per course x 4 courses = 100) via the short-course developed in aim #1;
  3. Create partnerships between oncology leaders and complementary practitioners (who provide the majority of complementary oncology services) within their communities (~25 community-based complementary partners per year {one per oncology leader} for a total of 100 over 4 years)
  4. Evaluate the impact of this short-course by measuring the process and the outcomes of the various educational activities over the course, and measuring the implementation and outcomes of the capstone projects initiated by participants at their home institutions after completion of the program;
  5. Disseminate the findings through peer-reviewed journals, presentations at professional meetings, and through both conventional and integrative oncology networks and associations.

So, basically, the NCI has spent nearly a half million dollars (thus far) to support this educational endeavor in two years, with three more years to go in the grant. One might ask: Why wasn’t NCCIH involved? As I’ve mentioned before, unfortunately the NCI has a very large CAM program; indeed its yearly budget is nearly as large as that of the NCCIH. The program is called the Office of Cancer Complementary and Alternative Medicine, which has one of the most cringe-inducing (in context) acronyms ever: OCCAM. A decade ago, I once spoke with a representative of OCCAM at the American Association for Cancer Research (AACR) meeting, and his blather about “emperor” and “assistant” herbs was every bit as cringe inducing as the OCCAM acronym.

So basically, the Integrative Oncology Scholars Program involves two parts. First, there is an online eLearning component implemented using a Canvas website designed by Instructure, Inc., in Salt Lake City. Second, there are three in-person sessions at—groan!—the University of Michigan. You’ll just have to excuse me if I remain…skeptical…about the eLearning modules, given that an evaluation of the U. of M. Department of Family Medicine eLearning module on acupuncture shows that it teaches acupuncture and traditional Chinese medicine (TCM) with great credulity and totally buys into the retconned version of TCM originally promoted by Chairman Mao.

The article by Zick et al actually isn’t that detailed regarding the curriculum. It does list the components of what will be taught in the three in-person sessions at U. of M. Predictably, there’s a lot on natural products and “mind-body” interventions, but there are also modules on dietary interventions both science-based and dubious (e.g., ketogenic, alkaline, paleo, macrobiotic, etc.). There’s also modules on energy medicine and traditional Chinese medicine. As far as the web-based modules, there are additional modules on:

  • Diet – (1) Ketogenic Diets, (2) Calorie-restricted Diets and Fasting, (3) Anti-oxidant Supplementation During Cancer Treatment, and (4) Soy and Cancer
  • Whole Systems of Medicine – (1) Homeopathy, (2) Ayurveda, and (3) Naturopathy
  • Unique Pharmacological Treatments – (1) Vitamin D, (2) High Dose Vitamin C, and (3) Melatonin
  • Botanical Products – (1) Cannabis and Cannabinoids, and (2) Mistletoe.

Homeopathy is, of course, The One Quackery to Rule Them All. Naturopathy is basically a cornucopia of quackery, while Ayurveda and TCM are prescientific systems of medicine whose resemblance to anything science-based tends to be purely by coincidence (e.g., Artemisinin). Meanwhile, high dose vitamin C has consistently been shown to be, at best given the most generous interpretation of the existing evidence, a long run for a short slide.

In other words, what we see here is the typical “integrative medicine” approach: Co-opt some science-based diet and lifestyle modalities—such as exercise, various dietary interventions (often mixed with the more dubious, like the ketogenic diet), and mindfulness (which might be science-based)—and use them for cover for the quackery, such as homeopathy, naturopathy, high dose vitamin C, that is included with the modalities to be “integrated.”

As for the methods, besides eLearning, here’s how the in-person sessions will be organized:

As part of the TBL model we will employ a flipped classroom approach. In the flipped classroom approach scholars will read key materials, watch lectures, or complete modules before coming to class, and then engage in active educational strategies to maximize educational effectiveness during in-person class time.14 These strategies will include group discussion sessions, case studies, as well as demonstration and role-playing. Cancer patients, their families, advocates, and community-based complementary providers will be invited to be part of the curriculum to bring their experiences into the learning environment. Use of TBL and flipped classroom strategies improve short-term outcomes in health professions’ curricula,15 and out-perform traditional lecture-based continuing medical education in both short-term knowledge retention and daily practice behavior.16

So, in other words, they’re trying to be very, very effective in indoctrinating oncologists and other health care professionals into believing in integrative oncology and referring patients to integrative practitioners, including quacks like naturopaths.

Finally, let’s look at the faculty who are teaching the Integrative Oncology Scholars Program. Suzanna Zick, a naturopath, is of course the course director. Another naturopath, Heather Greenlee, will also be teaching. The first thing you’ll notice is a relative paucity of actual oncologists in the list. There’s a medical oncologist and a radiation oncologist, as well as a PA in gynecologic oncology. That’s it. There are, however, psychologists and a nurse. For instance:

Judith M. Fouladbakhsh, PhD, RN, AHN-BC, PHCNS-BC, CHTP
Dr. Judi Fouladbakhsh, Associate Professor at Oakland University, and former faculty of long standing at Wayne State University, College of Nursing, holds advanced clinical practice certifications in Community Health and Holistic Nursing, Healing Touch, Reflexology and Reiki. Dr. J has extensive experience in complementary and alternative (traditional) medicine, integrative oncology, pain management, public health and cancer nursing. Research interests include effects of yoga on breathing, mood, sleep and QOL of lung cancer patients funded by the NIH, and yoga therapy and qigong for pain management among breast cancer survivors. She also serves as faculty at the Beaumont Health System School of Yoga Therapy.

How depressing. She has apparently been faculty at my current medical school for a long time. Worse, she’s into healing touch and reiki, forms of “energy medicine” that rely on belief in the existence of a mystical magical “energy field” that healers can manipulate to healing effect. As I’ve said more times than I can remember, reiki, for instance, is nothing more than faith healing in which Eastern religious beliefs are substituted for Christian religious beliefs. Unfortunately, nonsense like reiki is available and promoted in far too many NCI-designated comprehensive cancer centers.

There’s also an acupuncture researcher:

Dr. Richard Harris, PhD
Richard Harris is an Associate Professor in the Department of Anesthesiology and the Department of Internal Medicine at the University of Michigan. He received his Ph. D. in Molecular and Cell Biology from UC Berkeley in 1997. Dr. Harris is currently investigating mechanisms of acupuncture and acupressure in the treatment of chronic pain and fatigue conditions. His recent investigations have focused on the role of brain neurotransmitters in acupuncture analgesia and chronic pain.

Teaching focus areas: Pain; acupuncture/acupressure; traditional Chinese medicine; diet, exercise, and supplements in cancer prevention, cancer treatment and survivorship; GI disturbances

I perused Dr. Harris’ PubMed publication list (note that he is not this Richard Harris). There’s surprisingly little about acupuncture there, but what is there is pretty credulous, including a publication in JACM about how acupuncture “rewires” the brain with lasting effects and an article in the quack journal Medical Acupuncture about how cellular reorganization plays a vital role in acupuncture anesthesia. In other words, it’s quackademic medicine at its purest, and much of what will be taught to these “integrative oncology scholars” will either not be science based or will be a co-opted version of science based treatments framed as “integrative or alternative.” No big surprise there.

The Integrative Oncology Scholars Program: The goal

In the end, what is the goal of the Integrative Oncology Scholars Program? Clearly, it’s to increase the number of believers in integrative oncology in key locations, particularly academic medical centers (which, truth be told, are already hotbeds of pseudoscience). The investigators even have metrics that they want to look at for their “graduates” and their program:

To evaluate the IOS Program, we will use a mixed method approach employing tools developed from the University of Michigan Integrative Faculty Scholars Program in Integrative Healthcare and modified for the IOS Program. Overall, the IOS evaluation plan is composed of three elements: (1) evaluate overall IOS Program progress, (2) monitor individual IOS advancement, and (3) evaluate the IOS Program and make adjustments for subsequent cohorts, as needed.

We will also assess IOS progress toward nine goals focused on building IO research, clinical and educational impact: (1) writing applications for IO NIH funding, (2) authorship of IO publications, (3) presenting at IO-related conferences, (4) academic appointments to a faculty (or equivalent) position, (5) gaining employment in an IO team, (6) obtaining an IO leadership position, (7) individual IO-focused research grant support from NIH or other sources, (8) leadership as an IO “resource” person, and (9) improved IO clinical skills and knowledge as measured by a self-assessment tool.

The first cohort of 25 scholars is already well into the training, too:

The first cohort of 25 IOS has been accepted and will begin the program in August, 2018. The cohort is comprised of 10 physicians from radiation, medical, and surgical oncology as well as primary care, dermatology, and palliative care; 5 advanced practice nurses; 5 social workers; three physician assistants; 1 pharmacist; and 1 physical therapist. Several of the social workers and nurses coordinate cancer survivorship programs at their institutions. IOS come from 13 states and the District of Columbia and represent 23 U.S. healthcare systems, including comprehensive cancer centers (refer to Fig. 1).

It’s interesting to me that a minority of the first cohort are physicians and an even smaller minority appear to be from oncology-related specialties. Perhaps there is hope after all. On the other hand, this is only the first year. One can expect this program, if successful, to grow and metastasize to other institutions.

Now excuse me while I go and find a paper bag to put over my head, given that it’s my alma mater that’s leading this effort.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

43 replies on “The Integrative Oncology Scholars Program: Indoctrinating oncology professionals into pseudoscience”

yes well while all this effort goes into vaxanators they are injured & die by the dozens in the usa how u dont get gun control has got me beat ??? we had a one only 48 dead about 20 years ago …that was it …the australia govt @ the time made everybody hand in repeating & automatic guns of all size & type & paid the owners … nobody owns & carry hand guns here or carry the same in cocealment is not lawfull….yes i see the gun lobby runs the show & holds a big block of votes that pollys want .hmm sorry u can do nothing about it …just keep on about this stuff ..sooner or later some one will get some balls ..happy bob from oz..

Bob, your timing is really unkind. I’m pretty sure everyone here is well aware of the problem with guns in America.

Also, the Australian government locks up children (who haven’t committed any crime) until they go on hunger strike, so it’s not like you get the moral high ground.

Please go find someone else to bother.

I feel a similar pain, Orac,

I still can’t get the sick feeling out of my stomach when I think about my nursing student who brought “Lyme Literate” quackery into my classroom after I told her not to.

I had to rewrite the criteria for the assignment to keep it from happening again. Sadly, not all my colleagues saw this as seriously as I did. One of them even told me, “Panacea, you know the body heals in many ways.” Which, as a holistic care provider I do agree with. But there’s being holistic, and then there’s being taken for a ride. Giving a patient a portacath so you can give them never ending IV infusions of ceftriaxone is not healing the body in a different way. It’s quackery, it’s abuse, and it’s immoral.

We don’t even teach CAM in the program I’m with now.

Thank. God.

Panacea writes,

One of them even told me, “Panacea, you know the body heals in many ways.”

MJD says,

Unbelievable, you quote a colleague using your nym (i.e., Panacea)….really? If you misquoted the colleague deliberately to conceal your professional name, shame on you. Furthermore, using a misquote (ie.,lie) and then thanking God at the end of your comment is absolutely shameful – It’s unethical and immoral.

@ Panacea,

Let’s do coffee when your in town, ok? 🙂

As usual, your reading comprehension, sucks, Michael.

Of course I use my nym instead of my real name. You don’t know my real name (for good reasons and you never will), and since no one else here (except possibly Orac, because I’ve emailed him) knows it either, it makes so much more sense to a simple anecdote.

But of course, you’re so humorless you have to use that as an excuse to pick sardonic nits.

“Giving a patient a portacath so you can give them never ending IV infusions of ceftriaxone is not healing the body in a different way. It’s quackery, it’s abuse, and it’s immoral.”

That’s nonsense. Even the most dogmatic doctor will provide for 30 days of IV Ceftriaxone in neurological cases, sometimes longer. No one does “never ending IV infusions”, most neurological cases do 30 days at most, then switch to oral antibiotics for any further treatment if needed. No need to be so hyperbolic.

Your claim would mean that previous studies with Lyme disease and antibiotic treatment must have been quackery, abuse and immoral. Is that what you really meant to say? I think you’ll end up finding yourself on the wrong side of the science in that debate eventually anyway, so you might as well get used to it.

I think I made it pretty clear that I consider so called “Lyme Literate” to be quackery. What was confusing about that?

I know of no indication that requires IV ceftriaxone for 30 days. “In neurological cases?” What does that mean? Is that code for chronic Lyme, a disease that does not exist?

Properly designed studies are not quackery or immoral. STUDIES. And the evidence for giving long term antibiotics for a non existent disease, well isn’t there. You produce it, and we’ll talk.

Until then, I stand by what I said.

Uhhh…Bob…glad you’re happy there, but this post has zero to do with guns, and it’s not even really about vaccines either. Maybe you were trying to comment on something else?

If you read bob’s comment backwards, his message becomes crystal clear. The Australian government is integrating laws that improve the countries safety and wellness (e.g., gun control, vaccinations). For example, here’s a complementary article about a vaccination crackdown in Australia:

https://www.theguardian.com/society/2015/apr/19/vaccination-crackdown-australia-announces-end-to-religious-exemptions

@ bob,

Alternatively, sorry if I misinterpreted your comment.

The more post nominal letters the more insecure as well.
Isn’t it considered a bit crass to list every qualification you have? I’d have thought the PhD was the trump card.
According to the gods of google CHTP stands for “Certified Hospitality Technology Professional”, although I doubt that to what it stands for here.

No, it’s common in alt med-world:
– there are many “degrees” ** given by alt med/ woo-fraught “institutions” – certified hypnotist, holistic health coach, nutrition schools.- “OMD”/”TCM” doctors, NDs- loads of appellations- as well as “PhDs” from diploma mills
– some woo-meisters both preface and follow their names e.g. Dr John Wilson, PhD
– some alties refer to their own people as “Doctor” and SBM physicians as “Mr” ( even when they’re not surgeons in the UK) thus, “Mr” Offit. “Mr” Novella etc.

** sorry for the excessive ” “s

Certified Healing Touch Practitioner

That only counts if you have a PGP fingerprint on the bottom of your business card.

The last one’s a bit fluffy. On the up side I have a bronze certificate in swimming (nearly drowned, there’s nothing lower than a bronze certificate) so maybe I can put that after my name now.

@Shelly:

I believe Arnold Rimmer in Red Dwarf listed ‘BSC, SSC’ after his name. (Bronze Swimming Certificate, Silver Swimming Certificate.)

The PHCNS-BC one is actually an ANCC accredited certification.

Including your advanced specialty certifications is common in nursing. It indicates expertise in your area. It’s similar to the diplomate level of expertise that physicians use. You have to take a test to get it, and sometimes there are other requirements as well. For example CORN (certified operating room nurse) requires active practice as an OR nurse to certify and recertify. Most require continuing education to renew. Some require you to retest, some don’t.

I’m skeptical about the other two.

Off-topic,

The last ~ten (10) years, Orac has ignored my offer to write a guest post. @ Orac, to relieve some of your apprehension and stress would you consider a joint post (e.g., Orac and MJD)?

Please advise.

@ Orac’s minions,

If this dynamic duo came to fruition, is there a historical or modern duo that would be comparable to Orac & MJD?

If this dynamic duo came to fruition, is there a historical or modern duo that would be comparable to Orac & MJD?

Maybe you and Walton could collaborate instead if yall could pool enough neurons to start a blog of your own, but I will concede that you yourself are far more obnoxious.

Although Mr Walton is usually OT and off the wall in general at the very least his comments led me to look up Wedge Island and I enjoyed seeing lovely videos and learning that it is for sale ( price slashed from 800K AUD to only 495K!). In addition, I’ve found that beach shacks are allowed so he may not be tossed if a new owner appears.
Now how often does an OT commenter lead to us actually learn something reality based? I do know lots about geography and travel but have never heard of Wedge Island.
On the other hand, MJD does not teach us anything.

What I can’t understand is that he tolerates the continuous insults of Orac’s minions . He may not learn but wouldn’t he at least be upset by this and either leave or try to clean up his act?
( As you know I can’t offer my opinion concerning why he does so).

Denice Walter writes,

On the other hand, MJD does not teach us anything.

MJD says,

Thank you for inspiring me, Denice. My goal is to write a guest post for RI (~ 2,000 words) and present it in the comment section as a twenty (20) part series – If I can’t get Orac’s permission, I’ll test his forgiveness.

Note: Each part of the series will begin with “Off-topic” in an effort to avoid Orac’s auto-moderating propensity.

Narad, if not helping me deal with sh!t, your neurons are better used helping me come up with a good blog title and a domain name. This fool isn’t worth your time. Unlike me. 😉

It appears that the spread of this [email protected] is accelerating in the manner of economic growth, and that there’s an “ecosystem” developing here, of mutual benefit by quackery promoters, practitioners, and their enablers including academic and hospital administrators, all of them feeding on the money supplied by patients and to some extent insurers.

OK, so:

Could it be reduced by in some way insisting on more rigorous qualifications on the part of administrators? For example requiring that those positions be filled by MDs with degrees from reputable schools (possibly with an additional requirement of peer-reviewd publications)? Or is that already occurring but the MDs in question are objectivity-compromised in some way?

To what extent is this trend a result of “demand-pull” (patients want it therefore hospitals etc. offer it to compete for patients), and to what extent is it a result of “supply-push” (quacks build nests in various institutions and persuade those institutions to sell their services to patients)? Or has that situation also become reciprocal where each part of the cycle reinforces the other?

Have any administrators been caught making cynical remarks along the lines of “we all know this is [email protected] but we’re offering it because it sells” or “if patients want to Darwinize themselves, that’s their business”?

I also get the sense that there’s some kind of implicit but deliberate social Darwinism going on with this, but I can’t quite put my finger on it at the moment.

Aside from selling, the altie stuff is cheap and easy to offer. So hospitals can put resources into treatments that don`t help cancer but which make it look like they are doing something. Funding is insufficient even in countries with single-payer, so even in the Great White North some of the hospitals are getting crunchy.

I doubt that many of the admins are doing this consciously, but people dont operate that way. They dont want, in their minds, to offer a cheap crap substitute, so they sign on to an ideology.

As noted by our esteemed host, alties are attempting to subvert medical and scientific qualifications. They are imperialist-political in intent and remember, they`re always the underdogs.

Your attempt to inquire into the economics is the right way to be looking at this in my opinion.

Hi Denice –

Interesting point about “signing onto an ideology.” That’s the defense mechanism of “deciding to believe the lie.” (I know the proper name for that one, but I can’t think of it at the moment!;-)

In a way, that’s “Maoist medicine” all over again. Mao: “We can’t afford to train real doctors yet, so let’s have some peasants run around poking people with pins and call it healing.” Modern capitalism: “We don’t want to to cut (our own) admin salaries to hire more real doctors, so let’s have some wooskis run around waving their hands in the air or poking people with pins, and call it healing.” Everything that’s old is “thousands of years old” and therefore “new” again.

And speaking of waving hands, check out the BBC story “Canada’s last witch trials: women accused of fake witchcraft.” Unintentional humor ensues. You’ll find it a real hoot, as we say in the States:

https://www.bbc.com/news/world-us-canada-45983540

Fake witchcraft in Canadian law essentially means using occult claims to defraud someone. At the end of the article they interview a real witch, a member of the Wiccan faith.

Quote:

“Fortune telling and phony psychics, it’s very easy to tell the difference generally by the price tag,” she says.

She charges for tarot readings, and believes genuine fortune tellers never tell clients they’re cursed or that they can cure an illness.

Instead, she says she offers general life advice, and clients have the choice whether to take her advice or not.

She says you shouldn’t have to prove that magic is real in order to practise it, or earn a living from it.

“If you’re going to invest $20, $40, $60 in a tarot reading and you find it’s irrelevant to you, or did you no good, why would that being any different than going to a reiki treatment and finding that didn’t work?” she asked.

“Would you charge a reiki practitioner with fraud?”

Unquote.

OK, so:

Firstly, I’ll agree that Wicca is a benign religion (essentially the worship of nature), and people should be able to practice it freely.

Second, if practitioners of religions want to charge for religious rituals, marketed as such, that’s not fraud and that’s OK. For example I would expect churches charge for baptisms and religious weddings. So in the Wiccan/pagan range of religions, we might also see things such as Tarot readings, prayers, and “nature/energy” stuff. So far still OK, even if we of the science-based universe don’t believe in whatever-it-is.

And at the end she makes a good point though perhaps unintentionally. “Would you charge a reiki practitioner with fraud?”

Yes, I would charge a Reiki practitioner with fraud if s/he made any claims to diagnose or treat an illness.

On the other hand, if a Reiki practitioner made only religious or spiritual (meaning/purpose of life, morality, and/or religious praxis) claims, and did not make medical claims (diagnosis/treatment) I see no reason to charge them with fraud.

Which gets us to:

We of science-based universe might want to consider, strategically, putting Reiki, acupuncture, etc., in the category of “religious practices and rituals” because they are based essentially on supernatural (above/outside of nature) claims.

At that point, insurers and health care institutions could be considered as offering religious services and rituals under their financial benefits.

And at that point, in the USA, an offer of one type of religious activity but not others, by a health care institution or insurance company, could very well be subject to an anti-discrimination lawsuit!

Bingo!

At which point, some of those institutions may seriously reconsider whether to offer acupuncture, Reiki, and the like, under their official institutional umbrellas.

Is this any good?, or did I just wander sleepily down a useless trail that gets us nowhere?

Oops, the above should have begun, “Hi RJ” because it’s in reply to RJ’s comment preceding it. sorry about that.

Gray Squirrel:

For years, I’ve observed this aptly named ecosystem as mutual enablement for business opportunities with recent spread into academic facilities as well.
Here’s the funny thing, a woo-fraught nutritionist may indeed talk up the merits of other alties – acupuncturists, chiro, reiki, energy medicine BUT stop short right where his** territory begins, So ONLY his vitamins, meal plan and superfoods are appropriate whilst the others… aren’t. In fact, some of them disparage other schools of thought which don’t correspond exactly to their own parameters: vegans refute paleos / Weston Pricers and vice versa but there are highly specialised healthy vegans as well.. All use spurious research and self-promotional “data”( usually small case studies, self-report, N=1, unrelated material etc)

** and it’s very often men but not exclusively

Hi Denice –

Good point: they talk up each other’s stuff, but don’t recommend competitors in their own branch of the tree of woo. It would not be surprising if there were informal social circles of mutual referrals. This also has potential to keep patients’ time & attention (not to mention money) tied up in the altie universe, thus all the less likely that they’ll receive (much less follow) contrasting science-based advice.

BTW check out my reply to RJ above, that erroneously started with “hi Denice,” asI think you might find it amusing. Key quote, “Would you charge a Reiki practitioner with fraud?” Potential hilarity ensues, and a possible route to remove some of the wretched hives that are presently being built in otherwise legit institutions.

@ Panacea ( 5:46 PM):

MJD discusses your misquotes / lies, ethics and morals? That are shameful?

That reminds me a little of woo-meisters talking about SBM’s “lies, immorality and unethical practice” while they basically make up research and “cures”, rooking people of their hard earned money.

About anonymity:
you are very smart to remain so especially because you teach somewhere. I wouldn’t put it past many of our critics to harass you in RL as they did Orac, Rene, Dorit and others

I don’t used my full name, leaving of the second last name: I did so primarily because of people like Jake Crosby and those I critique regularly
( HOWEVER I sometimes worry about a lady in Tasmania who uses the same nym, spelt the same way – her real name).

To play the devil’s advocate for a moment : Would it not be good to teach oncologists to recognize these Alt-Med modalities scams and so be able to work around them so that their patient still receives the best quality care possible ? I mean, if Mr Jones, after having been advised that herbal stuff isn’t really going to help him, and that the overwhelming majority of supplements have no positive effect over and above that of a placebo, still opts to take lawngrass juice or something, would it not be better to be able to plan Mr Jones’ treatment with the understanding of how his lawngrass juice enemas are going to interact with his chemotherapy ? Or would it just be a waste of time ?

@ DLC:

Although no education is without merit, I would tend to think that oncologists who advocate SBM/research would understand that woo doesn’t work because they understand how cancer works and the mechanisms of action of its treatments. Of course, pharmacology already knows how woo ingredients interact with meds and other treatments- that’s why patients are instructed to list all OTC meds, vitamins, herbs that they take.

I assume though that learning to counsel people who have been frightened by alt med scares and who buy into its treatment plans might be valuable: how does a doctor deal with patients who are frightened of their illness AND misinformed about SB treatments so much that they lean upon the crutches of woo? How do you educate someone who has been mis-educated?
I imagine that this task wouldn’t be very different from trying to deal with people who have bought into anti-vax tropes: hard.

Alt med, through self-promotion, social media and clueless journalism, has poisoned what many people think SBM is. The stuff I hear/ read on a regular basis is frightening, imagine what a person who has been so indoctrinated and now has to face a diagnosis and treatment plan based upon SBM? That’s one of the reasons I despise alt med so much: it increases the emotional suffering of people who are ill to begin with and now are frightened needlessly, often so much that they might eschew realistic, research based treatment.

[…] Basically, what Shelly Latte-Naor and Jun Mao are presenting is their idealized version of integrative medicine that brooks no quackery (other than acupuncture, of course), where every intervention used is rigorously science-based. This is a typical portrait of integrative medicine painted by academics. They are science-based; so they can’t imagine that their specialty would not be, even as it embraces quackery. This version of integrative medicine and oncology leaves out the pseudoscience and quackery that the specialty really embraces. It’s even worse than that. The Society for Integrative Oncology allows naturopaths to join, which is embracing far more quackery than just acupuncture, given that naturopathy is a veritable cornucopia of quackery. Indeed, the organization has even elected two naturopaths as its president in the past, Heather Greenlee and Suzanna Zick! […]

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